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Earaches and Your Child


  • Pain or discomfort in or around the ear.
  • Child reports an earache.
  • Younger child acts like she did with previous ear infection (eg, crying, fussy).


  • Usually due to an ear infection.
  • Ear infections can be caused by viruses or bacteria. Usually, your child’s doctor can tell the difference by looking at the eardrum.
  • Ear infections peak at ages 6 months to 2 years.
  • The onset of ear infections peaks on day 3 of a cold.

Return to School

  • An earache or ear infection is not contagious. There is no need to miss any school or child care.

When to Call Your Doctor

Call 911 Now (Your Child May Need an Ambulance) If

  • Not moving or very weak

Call Your Doctor Now (Night or Day) If

  • Your child looks or acts very sick
  • Earache is severe and not improved 2 hours after taking ibuprofen (eg, Advil)
  • Pink or red swelling behind the ear
  • Stiff neck (can’t touch chin to chest)
  • Pointed object was inserted into the ear canal (eg, pencil, stick, wire)
  • Weak immune system (eg, sickle cell disease, HIV, chemotherapy, organ transplant, chronic steroids)
  • Fever above 104°F (40°C) and not improved 2 hours after fever medicine

Call Your Doctor Within 24 Hours (Between 9:00 am and 4:00 pm) If

  • Earache, but none of the symptoms described previously (Reason: possible ear infection)
  • Pus or cloudy discharge from ear canal

Home Care Advice for Suspected Ear Infection (Until Your Child Can Be Seen)

  1. Reassurance
    • Your child may have an ear infection. The only way to be sure is to examine the eardrum.
    • Diagnosis and treatment can safely wait until morning if the earache begins after your child’s doctor’s office is closed.
    • Ear pain can be controlled with pain medicine and ear drops.
  2. Pain or Fever Medicine: Give acetaminophen (eg, Tylenol) or ibuprofen (eg, Advil) as needed for pain relief or fever above 102°F (39°C).
  3. Local Cold: Apply a cold pack or a cold, wet washcloth to the outer ear for 20 minutes to reduce pain while the pain medicine takes effect (Note: some children prefer local heat for 20 minutes).
  4. Ear Drainage
    • If pus or cloudy fluid is draining from the ear canal, the eardrum has ruptured from an ear infection.
    • Wipe the pus away as it appears.
    • Avoid plugging with cotton (Reason: retained pus causes irritation or infection of the ear canal).
  5. Ear Drops: 3 drops of olive oil (or prescription ear drops) will usually relieve pain not helped by pain medicine. If your child has ear tubes or a hole in the eardrum, don’t use them.
  6. Contagiousness: Ear infections are not contagious.
  7. Call Your Doctor If
    • Your child develops severe pain.
    • Your child becomes worse.

And remember, contact your doctor if your child develops any of the “Call Your Doctor” symptoms.

Last Updated
My Child Is Sick! Expert Advice for Managing Common Illnesses and Injuries (Copyright © 2011 Barton D. Schmitt, MD, FAAP)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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